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Short sleep and physical inactivity are independently and jointly associated with prevalent cardiovascular disease in US adults

In a cross-sectional study of 1,577,591 US adults, short sleep (OR 1.26, 95% CI 1.22-1.30) and long sleep (OR 1.17, 95% CI 1.13-1.21) were independently associated with prevalent cardiovascular disease, as was physical inactivity (OR 1.11, 95% CI 1.09-1.14). The joint effect of short sleep and inactivity conferred the highest risk (OR 1.38, 95% CI 1.31-1.44), with no significant additive interaction (RERI -0.03, 95% CI -0.11 to 0.06), suggesting independent, additive risks.

Last updated: Aug 15, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Independent and joint associations of sleep duration and physical activity with cardiovascular disease: a cross-sectional study of 1.6 million US adults.

observational

Jin Y, Gong Z, Ming L, Gu J, Zhao X · Frontiers in public health (2026)

Participants: N/A
Duration: Cross-sectional (2014-2022 data)
Intervention: Observational analysis of sleep duration and physical activity levels (no intervention)
Outcome: Prevalent cardiovascular disease
Effect Size: OR 1.38 (95% CI 1.31-1.44) for joint short sleep and inactivity
Population: US adults (n=1,577,591) from the Behavioral Risk Factor Surveillance System (2014-2022)

Result:

PubMed: 42582514DOI: 10.3389/fpubh.2026.1886068

Mechanism Graph

Short sleep and physical inactivity are independently associated with cardiovascular disease risk
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The joint effect of short sleep and inactivity is higher than either alone
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No significant additive interaction (RERI -0.03) indicates no synergy beyond additive effects
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Result: Both factors contribute independently to cardiovascular risk, supporting combined lifestyle interventions

Limitations

  • ⚠Cross-sectional design cannot establish causality
  • ⚠Self-reported sleep duration and physical activity may introduce measurement bias
  • ⚠Residual confounding from unmeasured variables (e.g., diet, stress) despite rigorous adjustment

Frequently Asked Questions

What is the risk of cardiovascular disease for people with short sleep and physical inactivity?▼

The joint effect of short sleep and physical inactivity was associated with a 38% higher odds of prevalent cardiovascular disease (OR 1.38, 95% CI 1.31-1.44) compared to those with normal sleep and adequate activity.

Is there a synergistic interaction between sleep duration and physical activity?▼

No, the relative excess risk due to interaction (RERI) was -0.03 (95% CI -0.11 to 0.06), indicating that the risks are additive and independent, not synergistic.

What were the independent effects of short sleep and long sleep?▼

Short sleep was associated with a 26% higher odds (OR 1.26) and long sleep with a 17% higher odds (OR 1.17) of prevalent cardiovascular disease, compared to normal sleep.

What is the recommended public health approach based on this study?▼

The study suggests integrating sleep hygiene and physical activity into holistic '24-h movement' prescriptions to reduce cardiovascular disease risk.

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References

  1. 1.Jin Y, Gong Z, Ming L, Gu J, Zhao X. "Independent and joint associations of sleep duration and physical activity with cardiovascular disease: a cross-sectional study of 1.6 million US adults.." Frontiers in public health, 2026. PMID: 42582514 DOI: 10.3389/fpubh.2026.1886068
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.